Engineering Evaluation

Please advise the purpose of this evaluation:

New Project R&D Quotation Engineering Feasibility

Project Name *

Date Reply Needed *

1. COMPANY/CONTACT INFORMATION

Company *

Your Web URL *

Address

Address 2

City

State

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Zip Code

Your Name *

Title *

Email *

Phone*

Ext.

Fax

2. APPLICATION DATA

Part Name/Number *

Substrate Material*

Brief Description of Application and End Use *

Present Coating *

What needs to be improved with
your present coating or service? *

Describe the cleaning method used on raw components before they are sent in for coating application.

Type of Sterilization

ETO or Gamma Radiation

Cycle Temperature

Cycle Humidity

3. FUNCTION

What function do you expect the coating to perform? *

4. RATE THE IMPORTANCE OF THE FOLLOWING CHARACTERISTICS AND PROVIDE SPECIFICATIONS OF THE APPLIED COATING

(Rating – enter a number from 0-6)
6: most needed
1: least needed
O: not needed

5. QUALITY TESTING REQUIREMENTS

IPA Rub Test

Adhesion - Tape Test

Visual Testing - Magnification

List any other testing that is required of the coating.

6. PRODUCTION DATA/TIMELINE

Yearly Production

Lot Size(s)

Timeline

Now 0-30 Days 31-90 Days 90-120+ Days

7. DIMENSIONS & MASKING *

8. SPECIAL ASSEMBLY, TESTING PACKAGING OR SHIPPING REQUIREMENTS

Please note any special assembly, testing packaging or shipping requirements.